GIORGIO PERETTI, MD; PIERO NICOLAI, MD; CESARE PIAZZA, MD; LUCA O. REDAELLI DE ZINIS, MD; SERGJO VALENTINI, MD; ANTONINO R. ANTONELLI, MD

BRESCIA, ITALY

A cohort of 88 patients with glottic cancer (13 Tis, 75 Ti) who underwent endoscopic CO2 laser excision between January 1995 and June 1997 was prospectively studied. The mean follow-up was 43 months (range, 30 to 60 months). The depth and extent of the excision (graded according to the European Laryngological Society Classification, which includes 5 types of resection) were based on the results of a preoperative and intraoperative diagnostic test battery. Five patients died of other diseases, but none of glottic cancer. Of the 12 patients who developed a local recurrence, 5 underwent a second endoscopic procedure, 5 a total laryngectomy, and 1 a supracricoid laryngectomy, and 1 was treated with radiotherapy. The 5-year local control rate with endoscopic surgery alone, according to the Kaplan-Meier method, was 91%. None of the variables (8 related to the tumor and2 to the treatment) tested in aunivariate analysis by the log-rank test was found to have a significant impact on disease-free survival. The present study confirmed that endoscopic partial cordectomies for Tis-Tl glottic cancer can be regarded as valid alternatives to radiotherapy in terms of oncological results.